An update

Things have moved so quickly around here that I’ve not been able to provide an update on the CT scan I had done a couple weeks back:

Findings:
Chest:   Right chest wall port catheter terminates in the superior right atrium. The visualized thyroid is unremarkable.
Heart size is normal. Trace pericardial fluid. No pleural effusion. The central airways are patent. No suspicious pulmonary nodules. Stable granulomas in the right lung base.No mediastinal, hilar, axillary or supraclavicular lymphadenopathy.
Abdomen and pelvis:
Heterogeneous areas of geographic low attenuation throughout much of the right hepatic lobe, consistent with postradiation embolization changes, and similar to recent CT scan. There is increasing enhancement of a left hepatic lobe lesion (series 2 image 128), as well as decreased conspicuity of two additional left hepatic lobe lesions (series 2 image 112). Additional multifocal metastatic disease is not significantly changed from prior examination, including a 1.4 cm caudate lobe lesion (series 2 image 22). The main portal vein is patent. No biliary ductal dilatation. Stable calcification of the gallbladder, which may represent metastatic disease. Unchanged portacaval and gastrohepatic lymph nodes. For example, a portacaval lymph node on image 123 measures 1.7 cm in short axis, previously 1.7 cm. Enlarged, possibly necrotic periceliac nodes are also seen.
Mild splenomegaly, similar to prior. The pancreas and adrenal glands are normal. Symmetric enhancement of bilateral kidneys. No hydronephrosis. No suspicious renal lesions.
The esophagus and stomach are normal. There is a single, mildly dilated loop of small bowel (series 2 image 173-203), gentle tapering to more decompressed bowel at either end, which may represent a focal ileus. Compared to the prior and may 2017, there is in the sigmoid mass at the site of the known primary (series 2 image 225) measuring 3.7 x 4.2 cm. Increasing perihepatic and diffuse ascites. No free air.
Bladder and prostate are unremarkable. No acute or aggressive appearing osseous lesions. The abdominal aorta and its central branches are patent and normal in caliber.
Impression:
1.  Post embolization changes in the right hepatic lobe with stable to slightly increased conspicuity of left lobe metastatic disease. Recommend continued attention on follow-up.
2.  Increased sigmoid mass compared to May 2017; this mass is stable compared to examination dated 8/7/2017.
3.  Stable retroperitoneal and perihepatic lymphadenopathy.
4.  Increasing abdominal ascites.
The main issue here are the ascites, as that’s what’s keeping me from going under the knife at this point. So my option 4 (from my last post) will have to wait. It’s option 2 – low doses of localized radiation therapy – for now, in an effort to reduce this constriction in my colon so I have some relief. I’ve already gone in for 4 of my 10 daily radiation sessions and I’m acquainting myself with the special side-effects of this particular method of torture treatment, which is mainly fatigue and some low-grade nausea. But I’m starting to get some relief as well, and between having 3 days off from the radiation — along with that great Virginia Tech win over West Va. last night — my strength and energy have rebounded over this past weekend; how long I can hang onto it for the rest of the treatment schedule remains to be seen. (Va. Tech plays about 3 cupcakes for the next few weekends so I have high hopes.)
Why I scheduled these daily treatments before going into work instead of at the end of the day, I have no idea…
More posts as soon as things change again, I promise. I’ve only now felt up to post and I’m already halfway down another path, the scenery changes quickly around here. I’m hoping after the rest of these treatments that I can let my body finally rest for a bit and heal after all I’ve been through this year. It’s been a much more aggressive year, treatment-wise, than last year, and I’m very much looking forward to the results when my liver is ready to be scanned again. I’m getting stronger again but I just need a time out to catch my breath, Coach.
We lost one of my musical heroes yesterday. Walter, thanks for letting me make crappy graphics on your band’s website way back when. Rest easy my friend.